CN107635613A - The equipment for artificial ventilation with monitoring chest compressions missing - Google Patents

The equipment for artificial ventilation with monitoring chest compressions missing Download PDF

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Publication number
CN107635613A
CN107635613A CN201680028348.9A CN201680028348A CN107635613A CN 107635613 A CN107635613 A CN 107635613A CN 201680028348 A CN201680028348 A CN 201680028348A CN 107635613 A CN107635613 A CN 107635613A
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China
Prior art keywords
duration
equipment
missing
chest compressions
computing device
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CN201680028348.9A
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CN107635613B (en
Inventor
埃里克·雅科
托马斯·潘诺斯
马尔索·里戈洛
让-克里斯多夫·理查德
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Air Liquide Medical Systems SA
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Air Liquide Medical Systems SA
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/021—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes operated by electrical means
    • A61M16/022—Control means therefor
    • A61M16/024—Control means therefor including calculation means, e.g. using a processor
    • A—HUMAN NECESSITIES
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
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    • A—HUMAN NECESSITIES
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    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H31/00—Artificial respiration or heart stimulation, e.g. heart massage
    • A61H31/004—Heart stimulation
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H31/00—Artificial respiration or heart stimulation, e.g. heart massage
    • A61H31/004—Heart stimulation
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    • A—HUMAN NECESSITIES
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    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
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    • A61M16/0057—Pumps therefor
    • A61M16/0066—Blowers or centrifugal pumps
    • A61M16/0069—Blowers or centrifugal pumps the speed thereof being controlled by respiratory parameters, e.g. by inhalation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/20—Valves specially adapted to medical respiratory devices
    • A61M16/201—Controlled valves
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    • A61M16/203—Proportional
    • A61M16/205—Proportional used for exhalation control
    • G—PHYSICS
    • G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
    • G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
    • G09B23/00—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes
    • G09B23/28—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine
    • G09B23/288—Models for scientific, medical, or mathematical purposes, e.g. full-sized devices for demonstration purposes for medicine for artificial respiration or heart massage
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
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    • A61H2201/16—Physical interface with patient
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    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
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    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
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    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
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    • A—HUMAN NECESSITIES
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    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5023—Interfaces to the user
    • A61H2201/5048—Audio interfaces, e.g. voice or music controlled
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/50—Control means thereof
    • A61H2201/5058—Sensors or detectors
    • A61H2201/5071—Pressure sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2230/00—Measuring physical parameters of the user
    • A61H2230/40—Respiratory characteristics
    • A61H2230/42—Rate
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/0015—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors
    • A61M2016/0018—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical
    • A61M2016/0021—Accessories therefor, e.g. sensors, vibrators, negative pressure inhalation detectors electrical with a proportional output signal, e.g. from a thermistor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/0027—Accessories therefor, e.g. sensors, vibrators, negative pressure pressure meter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
    • A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
    • A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
    • A61M2016/0039—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the inspiratory circuit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M16/00—Devices for influencing the respiratory system of patients by gas treatment, e.g. mouth-to-mouth respiration; Tracheal tubes
    • A61M16/0003—Accessories therefor, e.g. sensors, vibrators, negative pressure
    • A61M2016/003—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter
    • A61M2016/0033—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical
    • A61M2016/0042—Accessories therefor, e.g. sensors, vibrators, negative pressure with a flowmeter electrical in the expiratory circuit
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2205/00—General characteristics of the apparatus
    • A61M2205/50—General characteristics of the apparatus with microprocessors or computers
    • A61M2205/502—User interfaces, e.g. screens or keyboards
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    • A61M2205/00—General characteristics of the apparatus
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    • A61M2205/52—General characteristics of the apparatus with microprocessors or computers with memories providing a history of measured variating parameters of apparatus or patient
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61M2209/00—Ancillary equipment
    • A61M2209/08—Supports for equipment

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Abstract

One kind is used for the respiratory assistance apparatus (1) that gas stream is delivered to patient (P), and the respiratory assistance apparatus includes：For conveying the gas delivery conduit (2) of gas stream；Measurement apparatus (6), the measurement apparatus are designed to measurement and represent at least one parameter of the gas stream and supply at least one signal corresponding with the parameter；Signal processing apparatus (8), the signal processing apparatus are designed to handle the signal from the measurement apparatus and at least one information related to the execution of chest compressions (CT) and/or execution interruption are derived from the signal；Computing device, the computing device are designed to calculate at least one duration (tNCT) that chest compressions are interrupted or lacked；And storage device (12), the storage device are configured for recording the duration that the chest compressions are interrupted or lacked.

Description

The equipment for artificial ventilation with monitoring chest compressions missing
The present invention relates to a kind of artificial ventilation's equipment, artificial ventilation's equipment can carry out cardiac massage to ventilated patient Period use, so as to ensure monitoring by emergency care provider (such as emergency physician, fire fighter, nurse) carry out cardiac massage, Especially monitor the time without pressing；And it is related to the monitoring method that a kind of thus kind equipment uses.
In case of the cardiac arrest, when carrying out cardiopulmonary resuscitation (CPR), emergency care provider must endeavour to ensure chest Pressing is interrupted with most short possibility, never to stop exporting by heart caused by chest compression, and so as not to meeting Exhaust heart pump.
The time is referred to as the no blood time (that is, patient does not have the time of heart output), and the time is to suffer from The strong prognostic indicator that person survives in the case of no sequel.
It is necessary in initial no blood (or tNFInitially) and total no blood (or tNFAlways) between be distinguish between, this is initially without blood Stream is corresponding to the time (that is, duration) for starting to disappear between first chest compression in heart arrest, and total no blood is also Interrupted including all chest compressions (CT) during processing, the processing is by emergency service person (that is, by such as fire brigade The emergency care providers such as member, emergency physician) provide and also referred to as professional cardiopulmonary resuscitation.Each individually CT break periods It is referred to as " no CT times " (or tNCT).
This is represented by below equation：tNFAlways=tNFInitially+S(tNCT)
Wherein：S (tNCT) is the summation of the break period of all chest compressions.
In addition, it is contemplated that professional cardiopulmonary resuscitation stage system need implement artificial ventilation, the artificial ventilation is most The breathing gas of such as air is delivered via the patient interface of such as mask or intubation cannula by respiratory assistance apparatus in the case of number Performed to patient, therefore have the situation that many cardiac massages are interrupted (specifically to patient cannula, the section of analysis defibrillator Play, move patient etc.).
All these simple and numerous interruptions are difficult to quantify for medical worker.But these interruption danger Evil lease of life, and it is important that therefore it, which is identified,.
It will be readily understood that due to heart arrest people provide first aid first-aid personnel be busy with by implement chest by Pressure saves the life of this people, therefore he or she can not possibly carry out accurately to institute either with or without the duration for carrying out chest compression Count.
Therefore, problem is to can recognize that the total time without chest compression (CT) (T is total), that is to say, that people's (i.e. heart Dirty all standing and during CPR by respiratory assistance apparatus ventilate patient) " no CT " total duration.
Therefore, solution of the invention is related to a kind of respiratory assistance apparatus for delivering gas stream to patient (also It is to say, a kind of medical ventilator), the respiratory assistance apparatus includes：
- be used to convey gas stream, the gas delivery conduit of especially air,
- measurement apparatus, the measurement apparatus are designed to measurement and represent at least one parameter of the gas stream and supply The corresponding at least one signal of at least one parameter with representing the gas stream,
- signal processing apparatus, the signal processing apparatus are designed to processing from described in the measurement apparatus at least one Individual signal and derive from the signal and the execution of chest compressions (CT) and/or perform related at least one of interruptions and believe Breath,
- computing device, the computing device be arranged to calculate chest compressions interrupt or missing it is at least one continue when Between (tNCT), during this period, determine to interrupt to chest compressions (CT) by the signal processing apparatus or related at least one of missing Information, and
- storage device, the storage device are designed to record in the chest compressions calculated by the computing device Disconnected or missing at least one duration (tNCT).
Depending on environment, respiratory assistance apparatus of the invention or medical ventilator can be including one in following technical characteristic Item is multinomial：
- the measurement apparatus be designed to measurement represent the gas stream, selected from gas pressure (P) and gas flow rate (Q) At least one parameter of (specifically blowing the gas flow rate to patient or the gas flow rate that is breathed out by the patient).
- the measurement apparatus includes at least one gas pressure sensor or air flow rate sensor.
- the computing device is arranged to calculate some duration (tNCT) in succession that chest compressions are interrupted or lacked S (tNCT), interruption or the missing of chest compressions are determined during these duration.In other words, the computing device calculates Chest compressions interrupt or the summation S (tNCT) of multiple duration (tNCT) in succession of missing, can obtain in this way The total duration of chest compression missing (T is total).
- the computing device () be configured to by determine interrupts or missing these chest compressions interrupt or Duration (tNCT) S added together (tNCT) of missing come determine chest compression missing total duration (T is total), also It is to say, calculates the summation S (tNCT) of shrinkage-free different time (tNCT).
- the measurement apparatus and the computing device are arranged to be operated continuously, and its mode is continuously detection and counts Calculate any interruption or the missing of chest compressions.
- the equipment includes display device, and the display device is designed to show that chest compressions are interrupted or lacked at least One duration (tNCT) or the chest compressions interrupt or the total duration of missing (T is total).
- the signal processing apparatus includes at least one electron plate, preferably comprises and implement at least the one of at least one algorithm The electron plate of individual microprocessor.
- (being somebody's turn to do) electron plate includes the computing device.
- the computing device (also referred to as " computing device " or " calculator ") includes timer.
- the display device includes man-machine interface.
- the display device is including being used to check the screen of information, preferably touching screen and/or color/graphics.
- the computing device is arranged to make calculator carry out increment and/or stopping during cardiac massage, so as to permit Perhaps shrinkage-free duration (tNCT) based on all determinations measures the total time without chest compressions (T is total).
- the computing device is arranged to that patient is carried out to stop increasing calculator after cardiac massage it is determined that terminating Amount.
- the equipment includes regulation or selection device, and the regulation or selection device are designed to allow user (namely Say, first-aid personnel or similar personnel) input or select data.
- the regulation or selection device are designed to provide duration (or the tNF about initial no bloodInitially) letter Breath, the duration of the initial no blood, which corresponds to, to be started in patient's heart all standing and for example by first-aid personnel or live witness The time (that is, duration) to be disappeared between the first chest compression carried out to the patient.The initial no blood it is lasting when Between (or tNFInitially) can be approximate time.
- the regulation or selection device are designed to interact (that is, instructing lung ventilator) with lung ventilator and changed The ventilation parameters of delivering or input or selection data.
- the regulation or selection device, which are designed to that cardiac massage will be proceeded by, to be notified to give the lung ventilator.
- the computing device is arranged to：Pressed in response to user by activating regulation or selection device to start heart The instruction that rubs, start calculator carrying out increment so as to allow to hold based on the shrinkage-free of all determinations during cardiac massage The continuous time (tNCT) measures the total time without chest compressions (T is total).
- the man-machine interface includes the regulation or selection device, for example, one or more activation or select button, one or Multiple knobs, it is one or more slide vernier, or the like.
- the man-machine interface includes the touch screen with duration input unit (especially touch-button).
- the computing device is arranged to the duration (tNF of the initial no bloodInitially) and in the cardiac massage Total time (T total) of this in journey without chest compressions is added and thus derives the total duration of the no blood of patient (tNFAlways)。
- the equipment includes being designed to the storage device of storage information and/or data.
- the storage device includes at least one data storage memory, especially flash memory or the like.
- the storage device is arranged to store one or more ventilating modes, for example, volume ventilation (VAC), air pressure are led to One in gas (VPC, VSAI, CPAP, double horizontal pressure forces ventilation (Duo-Levels)), and/or interval ventilation (VACI, PVACI) Kind or various modes.
- the signal processing apparatus is arranged to continuously run and ensure detection with performing or not performing cardiac massage The corresponding chest compressions of item of information and described information is delivered to the computing device, its mode is depending on chest is received Contract (that is, chest massage) presence or missing and make the calculator increment or not increment.
- the signal processing apparatus and/or the computing device include at least one electron plate, are preferably to implement one or more (miniature) controller of algorithm.
- the man-machine interface and can be designed to display including related at least to the duration of acardia massage The multinomial information of one information, include the duration (tNF of the initial no bloodInitially), during the cardiac massage without chest The total time (T is total), and/or the total duration (tNF of the no blood of the patient that portion shrinksAlways)。
- the equipment includes reinitializing device, and the device that reinitializes is arranged to initialize the calculator or again Initialization, that is to say, that the calculator is set or reset into 000 (that is, zero).
- the device that reinitializes is arranged to count this after user has acted on the regulation or selection device Calculate device initialization or reinitialize and notify to give the lung ventilator so as to which cardiac massage will be proceeded by.In other words, the duration The calculator of " tNCT " when the lung ventilator starts (that is, the action of conversion patient is indicated according to user) is initialised For 000.
- the equipment includes being used to produce the device of report at the end of the cardiac massage intervention, that is to say, that including selected from Perform the duration of cardiac massage, the total duration (T is total) of chest compression missing, the duration of the initial no blood (tNFInitially), and/or the no blood total duration (tNFAlways) in the report of one or more information or the like.
Now will be more preferable from the detailed description for providing as non-limiting examples and being referred to reference to accompanying drawing below Ground understands the present invention, in the accompanying drawings：
- Fig. 1 shows the embodiment of the respiratory assistance apparatus according to the present invention, and wherein gas source is micro-blower, and And
- Fig. 2 is the chart that pressure and flow velocity to the gas of patient are blown according to present invention displaying, shows with and does not have The operation for having the period of chest compression and being carried out by lung ventilator.
Fig. 1 is the schematic diagram according to the ventilation auxiliary equipment of the present invention or the embodiment of medical ventilator 1.
The ventilation auxiliary equipment or medical ventilator include gas source 4, and the gas source is delivering Respiration assistance gas herein The motorization micro-blower (also referred to as turbine) of stream (typically air stream or oxygen-enriched air stream).Air is by the miniature drum Blower fan sucks via the one or more ingate 4a formed in the housing 9 of lung ventilator 1.
In alternative solution (not shown), gas source 4 includes being supplied with the Controlled valve of gas via inner conduit, inside this Conduit is in itself with gas reservoir or being connected to the gas supply wall dimple of gas pipeline network and being in and be in fluid communication (by means of by gas Body reservoir or wall dimple are connected to the flexible conduit of inner conduit).
Ventilating return 2,16 (also referred to as patient circuit) including one or more path, conduit or gas line can incite somebody to action The gas source 4 of lung ventilator 1 is fluidly connected to the gas of patient 20 by patient interface 3 (such as breathing mask or intubation cannula) Road.
Ventilating return 2,16 includes being used at least one inspiration limb 2 that breathing gas is delivered to patient 20.Ventilate back Road can also include being rich in CO by what patient 20 breathed out designed for collecting2Gas expiration branch road 16.
The exhalation flow rate sensor 17 that expiration branch road 16 includes being electrically connected to control device 5 (such as electron plate) is (such as warm Silk sensor), and also have the outlet valve 19 controlled by control device 5.Exhalation branch road 16 is going out at end via gas downstream Oral pore 18 and atmosphere, and its upstream end is connected to inspiration limb 2 via wye piece or is connected directly to patient interface 3.
There is provided measurement apparatus 6 (such as sensor and/or flow velocity), its can be designed to：Measurement represents gas stream At least one parameter, especially gas pressure or the gas flow rate (flow velocity that is whether blown into by respirator and/or by patient The gas flow rate of 20 exhalation)；And deliver at least one signal for the parameter for representing at least one measurement.
Measurement is carried out in the inspiration limb 2 in ventilation gas loop 2,16, and its mode is to allow to pass serving as gas The gas pressure in the inspiration limb 2 of conduit or flow velocity is sent to measure.In the embodiment that Fig. 1 is shown, measurement dress Put 6 outsides for being arranged at lung ventilator.However, according to another embodiment, the measurement apparatus can also be located in lung ventilator 1.
Once it has been measured that the one or more parameters for representing gas stream, this parameter through measurement are converted into generation At least one signal of the table gas stream, signal processing apparatus 8 is then transmitted the signal to (that is, typically filling When the electron plate of control device 5) and analyzed by the signal processing apparatus, so as to by the signal derive with it is rapid to heart Stop patient's progress cardiac massage it is relevant at least one of information, especially with chest compressions CT execution and/or performing interruption At least one related information.
Therefore, signal processing apparatus 8 forms a part for the control device 5 of lung ventilator 1 and including a kind of with implementing Or one or more electron plates of the one or more microprocessors of many algorithms.
Lung ventilator 1 extraly includes the computing device to be cooperated with signal processing apparatus 8, for example, counter or timer.
More precisely, the computing device is configured (that is, be designed and can) and is used in response to by signal Processing unit 8 detects what the item of information related to chest compressions (CT) interruption or missing was interrupted or lacked to calculate chest compressions Each duration (tNCT).
Calculate all duration tNCT in succession that chest compressions are interrupted or lacked and be added to obtain chest The total duration T of portion's pressing missing is total.
The chest compressions that storage device 12 such as flash memory allows record to be calculated by computing device interrupt or missing One or more duration (tNCT) and chest compression missing total duration T it is total.
Lung ventilator 1 extraly includes man-machine interface, and the man-machine interface includes can be by user (that is, for example anxious Rescue the medical worker of staff) activation one or more control buttons 11 and also include information display screen 7, it is described Man-machine interface preferably includes the touch screen with colored display, and its some regions forms operating key.
When signal processing apparatus 8 has been processed by one or more signals from measurement apparatus 6 and is pushed away via it When exporting the item of information characterized by the cardiac massage performed to patient 20, then the computing device starts to determining in contraction Disconnected or missing chest compressions interrupt or the various durations tNCT of missing is counted, that is to say, that the computing device is opened Beginning is added together so as to derive that the total duration T of chest compression missing is total from it by these duration.
Preferably, measurement apparatus 6 and computing device are arranged to be operated continuously, and its mode is continuously to detect chest Any interruption or any recovery of missing and cardiac massage that portion shrinks.
Preferably, the computing device is arranged to make to be directed to by activating regulation or selection device in response to user The instruction of the ventilating mode initialization of cardiopulmonary resuscitation in user (for example, pressed the button of instruction beginning cardiac massage Afterwards), start counter carrying out increment during cardiac massage, so as to allow based on the shrinkage-free lasting of all determinations Time tNCT is total to measure the total time T of no chest compressions.
Finally, lung ventilator 1 shows the duration tNCT or and chest that chest compressions are interrupted or lacked in man-machine interface Chest compressions corresponding all duration tNCT of interrupts or missing summation S (tNCT) are interrupted or missing is always held The continuous time (T is total).
There is provided for produce report device, for example, show at the end of intervention report or can at the end of intervention Report is fetched on USB memory device or the like.These devices for producing report are preferably designed in the cardiac massage Produce afterwards and intervene report, that is to say, that continue including the duration selected from execution cardiac massage, the total of chest compression missing Time T is total, the duration tNF of initial " no blood "Initially, and/or the total duration tNF of " no blood "AlwaysIn one or more Report of item information or the like.
Via suitable link (that is, electric link 10, such as cable etc.) between the different parts of lung ventilator 1 Transmission signal.
Lung ventilator 1 can also include carrying handle 13 and/or the fastening system 14 for being fastened to equipment on support member, Such as hook etc..Lung ventilator 1 can also transport in rigid case or flexible pouch.
Fig. 2 be displaying by according to the present invention lung ventilator (for example, Fig. 1 lung ventilator) blow to patient gas stream at any time Between t pressure P and flow velocity Q chart, can be to the period (stage a and c) with chest compression with not having from the chart The period (stage b) of chest compression makes a distinction and represented the operation carried out by respirator.
More precisely, when respirator 1 by analyze flow velocity Q from used flow velocity or pressure sensor 6 and/or Pressure P signal and when detecting the presence of cardiac massage (stage a and c), during lasting without chest compression to have disappeared Between tNCT be not incremented.
On the contrary, (the rank when respirator is by analyzing flow velocity Q and/or pressure P signal without detecting cardiac massage B), the duration tNCT without chest compression to have disappeared is incremented section, that is to say, that the duration is added to Other duration tNCT for being detected is had been able to before and is added to determine to reflect always holding for chest compression CT missings Continuous time T is total.
(stage d), respirator think patient in the case of the period without chest compression for a long time (such as 1 minute) Recover or abandoned recovery and attempted.In this stage e, counter tNCT no longer increments.
Know that tNCT will allow to calculate and show the percentage of the recovery time pressed, its mode is encouragement Medical worker never to interrupt chest compression with constantly close to 100% ideal value.We term it %CT index for this It is calculated as follows：
Hereafter, the duration, the total duration T of chest compression missing that carry out cardiac massage are total, initial " no blood " Duration tNFInitially, and/or the total duration tNF of " no blood "AlwaysIt can be displayed on the touch screen 7 of respirator 1 And/or the theme of the intervention report of medical worker can be intended for.
In general, artificial ventilation's equipment of the invention adapts to make during the cardiac massage to ventilated patient completely With to ensure cardiac massage of the monitoring by emergency care provider (such as emergency physician, fire fighter, nurse etc.) progress.

Claims (11)

1. one kind is used for the respiratory assistance apparatus (1) that gas stream is delivered to patient (P), the respiratory assistance apparatus includes：
- be used to convey the gas delivery conduit (2) of gas stream,
- measurement apparatus (6), the measurement apparatus be designed to measurement represent the gas stream at least one parameter and supply with The corresponding at least one signal of at least one parameter of the gas stream is represented,
- signal processing apparatus (8), the signal processing apparatus be designed to processing from the measurement apparatus (6) it is described at least One signal and derive from the signal and the execution of chest compressions (CT) and/or perform related at least one of interruptions and believe Breath,
- computing device, the computing device are arranged to calculate at least one duration that chest compressions are interrupted or lacked (tNCT) at least one related to chest compressions (CT) interruption or missing, during this period, is determined by the signal processing apparatus (8) Information, and
- storage device (12), the storage device are designed to record in the chest compressions calculated by the computing device Disconnected or missing at least one duration (tNCT).
2. the equipment as described in previous claim, it is characterised in that the measurement apparatus (6) is designed to measurement and represents the gas Body stream, at least one parameter selected from gas pressure (P) and gas flow rate (Q), the measurement apparatus (6) preferably include at least One gas pressure sensor or air flow rate sensor.
3. the equipment as any one of preceding claims, it is characterised in that the computing device is arranged to calculate chest Some duration (tNCT) of portion's interrupts or missing, the interruption of contraction is determined during these duration or lacks Lose.
4. the equipment as described in one of preceding claims, it is characterised in that the computing device is configured to determine These chest compressions of interrupts or missing interrupt or duration (tNCT) the phase Calais of missing determines that chest compression lacks The total duration of mistake (T is total).
5. the equipment as described in one of preceding claims, it is characterised in that the measurement apparatus (6) and the computing device () by with Put for being operated continuously, its mode is continuously detection and any interruption of calculating chest compressions or missing.
6. the equipment as described in one of preceding claims, it is characterised in that the equipment includes display device (7), display dress Put be designed to show chest compressions interrupt or missing at least one duration (tNCT) or the chest compressions interrupt or The total duration of missing (T is total).
7. the equipment as described in one of preceding claims, it is characterised in that the signal processing apparatus (8) includes at least one electricity Daughter board, the electron plate for preferably comprising at least one microprocessor for implementing at least one algorithm.
8. the equipment as described in one of preceding claims, it is characterised in that the display device (7) includes being used to check information Screen, it is preferably to touch screen and/or color/graphics.
9. the equipment as described in one of preceding claims, it is characterised in that the computing device is arranged to：In response to using Person starts the instruction of cardiac massage, starts to carry out calculator during cardiac massage by activating regulation or selection device Increment is so as to allowing the shrinkage-free duration (tNCT) based on all determinations to measure the total time (T without chest compressions Always).
10. the equipment as described in one of preceding claims, it is characterised in that the computing device includes counter or timer.
11. the equipment as described in one of preceding claims, it is characterised in that the electron plate includes the computing device.
CN201680028348.9A 2015-06-08 2016-04-28 Device for artificial ventilation with monitoring of absence of chest contraction Active CN107635613B (en)

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FR1555191 2015-06-08
FR1555191A FR3036971B1 (en) 2015-06-08 2015-06-08 ARTIFICIAL VENTILATION APPARATUS WITH MONITORING THE ABSENCE OF THERACY CONTRACTIONS
PCT/FR2016/051000 WO2016198757A1 (en) 2015-06-08 2016-04-28 Apparatus for artificial ventilation, with monitoring for absence of chest contractions

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CA2987434A1 (en) 2016-12-15
FR3036971A1 (en) 2016-12-09
JP2018521712A (en) 2018-08-09
WO2016198757A1 (en) 2016-12-15
ES2707373T3 (en) 2019-04-03
BR112017024798A2 (en) 2019-05-14
EP3218036A1 (en) 2017-09-20
US20180147378A1 (en) 2018-05-31
CN107635613B (en) 2020-09-25
EP3218036B1 (en) 2018-12-05
JP6684829B2 (en) 2020-04-22
FR3036971B1 (en) 2017-07-07

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